What Is Erectile Dysfunction? | Expert Guide

Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 15 Jun 2022

Erectile dysfunction is a very common condition that affects lots of men. But what is erectile dysfunction?

Despite being a common condition experienced by most men at some point in their lives, many people don’t know that much about erectile dysfunction — also known as ED, or less often, impotence. Lots of men struggle to speak openly and frankly about the condition and can often feel embarrassed about seeking help or asking questions.

That’s why we’ve created this guide, to give you some helpful information and guidance about erectile dysfunction.

In the guide below, we’ll answer some common questions that many people have about erectile dysfunction, including what causes erectile dysfunction, the link between erectile dysfunction and age, and erectile dysfunction treatment options. Read on to find out more.

What is erectile dysfunction?
What causes erectile dysfunction?
Is erectile dysfunction curable?
Psychological erectile dysfunction
Erectile dysfunction and age
Alcohol and erectile dysfunction
Erectile dysfunction treatment options

What is ED?

Erectile dysfunction (ED) is the inability to achieve and maintain an erection firm enough to have sexual intercourse, or in response to sexual stimulation.

Erectile dysfunction is sometimes referred to as impotence, although this term is used less frequently than it used to be.

ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have erectile dysfunction at some point or to some degree. However, ED can affect men at any age.

Erectile dysfunction definition

Occasional erectile problems aren’t uncommon; most men will sometimes fail to get or keep an erection. This is generally down to factors like tiredness, stress, or excessive alcohol consumption.

However, sometimes these problems with achieving and maintaining an erection can be more frequent and problematic. This is when we would classify this as erectile dysfunction.

Frequent ED may be a sign of health problems that need treatment, either physical or psychological. There are a few different conditions which can cause erectile dysfunction, which we will go into in more detail below.

If you aren’t sure if what you have is ED or not, find out more by reading our erectile dysfunction symptoms page.

What causes erectile dysfunction?

Erectile dysfunction can have many underlying causes.

These can be split broadly into three different categories: physical causes (such as certain medical conditions), psychological causes (such as stress or anxiety) or medicinal causes (medications which can cause ED).

It's important to identify the cause of erectile dysfunction so that both the erectile dysfunction and this underlying condition can be treated.

In the section below, we’ll go into greater detail about what can cause erectile dysfunction and the different reasons for erectile dysfunction.

Reasons for erectile dysfunction

There are many different causes and reasons for erectile dysfunction.

The most common reasons for erectile dysfunction are physical: it is estimated that as many as 80% of ED cases are caused by physical factors.

Psychological causes may also be a reason for erectile dysfunction, as can medicinal reasons. Certain medicines can lead to erectile dysfunction in some men.

Take a look at our dedicated page covering the main causes of erectile dysfunction for more information. We’ve also provided a brief overview of the causes below.

Physical causes of ED:

Vascular conditions - such as heart disease, high blood pressure (hypertension), cardiovascular disease and diabetes, all of which can affect blood flow to the penis

Hormonal conditions - conditions which affect the levels of hormones in the body, such as overactive or underactive thyroid, hypogonadism and Cushing’s syndrome

Neurogenic conditions - conditions which affect the nervous systems, such as multiple sclerosis and Parkinson’s disease

Anatomical conditions - conditions which affect the physical structure of the penis, such as Peyronie’s disease

Various lifestyle factors such as excessive smoking, drinking, obesity, high cholesterol, lack of exercise, or illegal substance abuse
Prostate cancer

Psychological causes of ED:

Mental health conditions such as anxiety and depression
Psychological factors such as stress
Relationship problems
Being in a new relationship
Feeling a lack of sexual knowledge and confidence
Low self-esteem
Past sexual abuse
Performance anxiety

Medicinal causes of ED:

Beta-blockers
Diuretics
Corticosteroids
Antidepressants (such as SSRIs)
Antihistamines
Cytotoxics

Can masturbation cause erectile dysfunction?

It is a common belief that masturbating too much can cause erectile dysfunction. You may have heard this masturbation erectile dysfunction myth, but it is just that — a myth.

Masturbation does not directly cause erectile dysfunction in men. Masturbation is perfectly normal and will not affect the quality or frequency of erections. It won't cause problems like ED when you have sex with a partner.

Is erectile dysfunction curable?

There are many different ways that erectile dysfunction can be treated.

Most cases of erectile dysfunction respond to medication. You will probably have heard of Viagra or other erectile dysfunction tablets. These medications (which can be prescription or over-the-counter) can help people with ED to achieve an erection and maintain it. For most people, they are not available from the NHS and need to be paid for privately from your GP or an online pharmacy like The Independent Pharmacy.

Erectile dysfunction can also be improved by treating the underlying cause, whether this is a physical or psychological problem like the ones we’ve listed above.

For example, if the underlying cause of ED is a physical issue such as a narrowing of penis blood vessels, high blood pressure or high cholesterol, you may be prescribed medicine to lower blood pressure or statins to lower cholesterol.

Your doctor may also suggest some lifestyle changes that will help to improve your general health and the condition itself, such as losing weight, eating healthily, regular exercise, reducing your alcohol intake or quitting smoking.

Psychological erectile dysfunction

As we’ve mentioned previously, erectile dysfunction can have a range of causes — both physical and psychological.

Psychological erectile dysfunction causes can include stress, anxiety, depression, low self-esteem, or relationship problems. This can be upsetting and distressful in itself, as it impacts your emotional relationship and sex life — sexual dysfunction can make you feel more stressed, anxious and low, which further feeds into the problem.

Some people may find that ED only occurs in certain situations — such as being unable to get an erection with a sexual partner but being able to during masturbation. If this is the case, it is likely the underlying cause of erectile dysfunction is psychological.

As with physical causes, psychological erectile dysfunction can be treated by tackling the psychological cause of the problem. This may be through cognitive behavioural therapy (CBT) or sex therapy.

Anxiety & erectile dysfunction

Anxiety and erectile dysfunction are linked: stress and anxiety can interrupt how your brain sends messages to the penis, which can do things like stop extra blood flow.

Unfortunately, this can lead to a vicious cycle: anxiety and stress cause erectile issues, which causes further anxiety — particularly when it comes to sexual performance. This is known as performance anxiety.

Feeling stressed and anxious about ED contributes to this ongoing cycle of ongoing erectile dysfunction.

Depression & erectile dysfunction

Many men and women with depression find that they experience changes to their sex drives — having little or no sexual desire.

For men, this can result in erectile dysfunction. Depression can cause ED even when a man feels completely comfortable in a sexual situation.

Some of the medication that is used to treat depression can also cause erectile dysfunction, such as some selective serotonin reuptake inhibitors — SSRIs — or tricyclic and tetracyclic antidepressants.

Erectile dysfunction and age

Erectile dysfunction is a very common condition that can affect any man at any age. There is no specific ‘erectile dysfunction age’.

ED does, however, become increasingly common as men get older; it is estimated that around 50% of men between the ages of 40 and 70 will experience erectile dysfunction at some point.

This doesn’t mean growing older means the end of your sex life; there are many erectile dysfunction treatments available that can help to treat the condition no matter what your age. Nor does it mean that erectile dysfunction is an inevitable part of ageing; some men will not experience ED.

While erectile dysfunction is more common in older men, it can also affect younger men for a number of reasons. In fact, ED cases in younger men are on the rise. You can find out more here about the causes and treatments for erectile dysfunction in young men.

Can high blood pressure affect erectile dysfunction?

High blood pressure and erectile dysfunction are linked. Vascular conditions — such as high blood pressure and cardiovascular disease — can affect the flow of blood to the penis, causing problems with achieving and maintaining erections.

These health problems are common physical causes of erectile dysfunction. Older men are generally at greater risk of developing these physical causes of ED, which is one of the reasons why erectile dysfunction is more common in older men.

Digestive and kidney diseases and ED

Kidney disease is linked to erectile dysfunction, with ED being a very common condition for patients with chronic kidney disease (CKD).

Erectile dysfunction is also highly prevalent among men with digestive diseases such as inflammatory bowel disease (IBD).

Alcohol and erectile dysfunction

As we’ve mentioned above, there are some lifestyle factors which may cause or contribute to erectile dysfunction.

Excessive alcohol consumption is one such cause: there is a link between alcohol and erectile dysfunction.

Most men occasionally fail to get or keep an erection when they have had too much alcohol, and this is usually nothing to worry about. However, in some cases, heavy and regular drinking can cause erectile dysfunction.

This is because heavy drinking can damage the blood vessels in the penis. This reduces blood flow and makes it harder for blood to get to the penis, causing erection problems and affecting erectile function.

Long-term alcohol abuse can also cause damage to the nervous system, which is responsible for triggering the signals that cause an erection.

Erectile dysfunction treatment options

Treatment for erectile dysfunction has improved significantly in recent years — ED treatments are much better than they used to be.

There are various erectile dysfunction treatment options that can help with the condition, many of which are highly effective and readily available. For many people, drug administration can effectively help treat ED.

In the section below, we’ll go over some of the most common treatments of erectile dysfunction.

How to treat erectile dysfunction: ED drugs & medication

Treatment for erectile dysfunction varies from case to case, depending on the underlying cause of the erection problems.

These may be prescription drugs, dietary supplements to help with underlying health problems, oral medications, over the counter drugs,

Your GP will be able to help you understand and investigate what the underlying cause of your erectile dysfunction is. They may suggest a physical exam or ask for blood tests, medical history, or any other necessary information. After this, they will be able to suggest different treatment options which will suit you best.

Here are some of the most popular ED medicines (we’ve split them into the four main tablets, the branded and generic versions):

Sildenafil (Viagra & generic Sildenafil)
Tadalafil (Cialis & generic Tadalafil)
Avanafil (Spedra)
Vardenafil (Levitra & generic Vardenafil)

There is a wide range of different erectile dysfunction treatments that are available at The Independent Pharmacy. Choosing the right one for you will depend on a variety of factors, such as your health, any other medication you take, and how your body reacts.

If you’re unsure which is best for you, we’ve written some helpful guides on erectile dysfunction, including treatment and comparisons, side effect guides and customer reviews (such as this Tadalafil reviews page).

How to treat erectile dysfunction: alternative treatments

There are also many other treatments available for ED, depending on the underlying cause of your condition, such as:

Sex therapy
Surgical treatment options
Penile injections
Penile implants
Penile creams
Vacuum pumps
Hormone treatment
Natural remedies

If your erectile dysfunction is caused by an underlying health condition such as diabetes or cardiovascular disease, then that condition may need to be treated first. Treating this may also help to resolve erectile dysfunction.

Likewise, if your ED is caused by a mental health problem such as anxiety or depression, seeking treatment for this — such as cognitive behavioural therapy — may help to improve erectile dysfunction, as well as treating the underlying mental health issue.

Your doctor may also review any medication that you are currently taking — certain medicines can cause erectile dysfunction, so they may suggest an alternative.

If you want to explore a more natural approach, take a look at our in depth guide that covers natural remedies for erectile dysfunction.

Erectile dysfunction / ED: a summary

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough to have sexual intercourse. It is sometimes referred to as impotence, although this term is used less often now.

ED is a very common condition, especially in older men — it is estimated that 50% of men between the ages of 40 and 70 will have erectile dysfunction to some degree. However, it is worth noting that ED can affect men at any age.

There are many different causes of erectile dysfunction. These generally come under one of three different categories: physical causes (such as certain medical conditions like diabetes, cardiovascular disease or health problems such as obesity), psychological causes (like stress, anxiety or depression) or medicinal causes (medications which can cause ED).

It is important to establish what is causing ED. Treating the underlying cause of erectile dysfunction can help to resolve ED too.

If you are suffering from erectile dysfunction, then there are many different treatment options which can help.

Here at The Independent Pharmacy, we offer a wide variety of erectile dysfunction treatments. All you need to do is complete a quick and easy online consultation (which is free to do) to receive your medication discreetly.